A technical report from the Italian SARS-CoV-2 outbreak. Postmortem sampling and autopsy investigation in cases of suspe
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TECHNICAL REPORT
A technical report from the Italian SARS-CoV-2 outbreak. Postmortem sampling and autopsy investigation in cases of suspected or probable COVID-19 Alessandro Santurro 1 & Matteo Scopetti 1 & Stefano D’Errico 2 & Vittorio Fineschi 1 Accepted: 24 April 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) is a coronavirus responsible for COVID-19 (coronavirus disease 2019) which resulted in a cluster of cases of pneumonia that originated in China around 31 December 2019 and has subsequently spread across the globe. Currently, COVID-19 represents a health emergency worldwide, leading, in severe cases, to pneumonia, severe acute respiratory syndrome, multiorgan dysfunction or failure, and death. In the context of limited scientific knowledge and evidence of SARS-CoV-2 infection, guidance is becoming increasingly necessary for pathologists who have to perform postmortem investigations on COVID-19 cases. The aim of the present report is to share a procedure applicable to cases of COVID-19-related death, particularly in cases of death without medical intervention and in the absence of an ascertained SARSCoV-2 infection and/or COVID-19 diagnosis, therefore providing support for diagnostic activity in the present COVID-19 pandemic. For this purpose, a standard operating procedure for correct swab collection, autopsy investigation and tissue sampling is provided. Keywords SARS-CoV-2 . COVID-19 . Virological diagnosis . Autopsy investigation . Postmortem diagnosis
Hic est locus ubi mors gaudet succurrere vitae “This is the place where death delights in helping life”
Introduction SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) is a coronavirus responsible for COVID-19 (coronavirus disease 2019) which resulted in a cluster of cases of pneumonia that originated in China around 31 December 2019 and has subsequently spread across the globe. Currently, COVID-19 represents a health emergency worldwide, leading, in severe * Vittorio Fineschi [email protected] 1
Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Viale Regina Elena 336, 00185 Rome, Italy
2
Department of Medicine, Surgery and Health, University of Trieste, Strada di Fiume 44, 34149 Trieste, Italy
cases, to pneumonia, severe acute respiratory syndrome, multiorgan dysfunction or failure, and death [1]. Measures and recommendations have been developed to help healthcare personnel prevent the spread of the virus and to properly manage COVID-19 cases, advising on possible risks and preventive measures [2]. In the context of limited scientific knowledge and evidence of SARS-CoV-2 infection, guidance is becoming increasingly necessary for pathologists who have to carry out postmortem investigations on COVID19-related deaths [3–5]. The aim of the present report is to share a procedure for correct swab collection and autopsy investigations, offering technical support to professionals involved in these act
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